Prolongation of the retinal mean circulation time in diabetes

Retinal mean circulation time (MCT) and vascular sizes were measured in 21 normal individuals and 32 individuals with diabetes, and segmental blood flow (SBF) was calculated. The MCT was similar in the normal individuals (4.0 +/- 1.1 s) and the individuals with diabetes (4.2 +/- 1.9 s) when seven individuals with diabetes with prolonged but not quantifiable MCT were excluded. Including them by nonparametric statistics revealed that MCT was significantly longer in individuals with diabetes with proliferative retinopathy than in normal individuals or in individuals with diabetes with nonproliferative retinopathy. The prolonged MCT correlated significantly with advanced retinopathy as judged by leakage, neovascularization, and the need for photocoagulation therapy. Reduced SBF may account for the prolonged MCT, since the increase in vascular sizes observed failed to do so. However, pathologic vascular changes may alter the relation between SBF and MCT. Irrespective of implications about SBF, prolonged MCT, which indicates marked circulatory disturbance, represents an important new observation in diabetic retinopathy.